Lee Kyungmin, Won Je Hwan, Kwon Yohan, Lee Su Hyung, Bang Jun Bae, Kim Jinoo
J Korean Soc Radiol. 2023 Jan;84(1):197-211. doi: 10.3348/jksr.2022.0069. Epub 2023 Jan 18.
To evaluate the circuit patency after nitinol bare-metal stent (BMS) placement according to the type of access and location of the stent in dysfunctional hemodialysis access.
Between January 2017 and December 2019, 159 patients (mean age, 64.1 ± 13.2 years) underwent nitinol BMS placement for dysfunctional access. The location of stents was as follows: 18 brachiocephalic vein, 51 cephalic arch, 40 upper arm vein, 10 juxta-anastomotic vein, 7 arteriovenous (AV) anastomosis, and 33 graft-vein (GV) anastomosis. Circuit patency was evaluated by the Kaplan-Meier method, and cox regression model.
A total of 159 stents were successfully deployed in 103 AV fistula (AVF) and 56 AV graft (AVG). AVG showed lower primary and secondary patency at 12-months compared with AVF (primary patency; 25.0% vs. 44.7%; = 0.005, secondary patency; 76.8% vs. 92.2%; = 0.014). Cox regression model demonstrated poorer primary patency at 12 months after stenting in the cephalic arch and GV anastomosis compared with the other sites.
AVF showed better primary and secondary circuit patency at 12 months following the placement of BMS compared with AVG. Stents in the cephalic arch and GV anastomosis were associated with poorer primary patency at 12 months compared to those in other locations.
根据功能失调的血液透析通路中支架的接入类型和位置，评估镍钛诺裸金属支架（BMS）置入后的通路通畅情况。
2017年1月至2019年12月期间，159例患者（平均年龄64.1±13.2岁）因功能失调的通路接受了镍钛诺BMS置入。支架位置如下：头臂静脉18例，头静脉弓51例，上臂静脉40例，吻合口附近静脉10例，动静脉（AV）吻合口7例，移植静脉（GV）吻合口33例。采用Kaplan-Meier法和Cox回归模型评估通路通畅情况。
共159枚支架成功植入103例动静脉内瘘（AVF）和56例动静脉移植物（AVG）。与AVF相比，AVG在12个月时的初级和次级通畅率较低（初级通畅率；25.0%对44.7%；P = 0.005，次级通畅率；76.8%对92.2%；P = 0.014）。Cox回归模型显示，与其他部位相比，头静脉弓和GV吻合口支架置入后12个月的初级通畅情况较差。
与AVG相比，BMS置入后12个月时AVF的初级和次级通路通畅情况更好。与其他位置相比，头静脉弓和GV吻合口的支架在12个月时的初级通畅率较差。
